Anterior cervical discectomy and fusion classification [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Anterior cervical discectomy and fusion classification ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/12CQgEfkYEaheZoU1wFXlppAaudw-jExu-pHURp6bJ6MUqdQnx/?limit=15&utm_campaign=pubmed-2&fc=20250107032118}}

[[Anterior cervical discectomy and fusion]] procedures can be classified based on several criteria, including the number of levels treated, surgical technique, and the type of implants used. 


### **1. Based on the Number of Levels Treated**
- **Single-level ACDF:**  
  Fusion between two adjacent vertebrae (e.g., C5-C6).
  
**[[Multiple-Level Anterior cervical discectomy and fusion]]**  
  Fusion involving three or more vertebrae (e.g., C4-C6).
  
[[Two-level cervical discectomy and fusion]]


---

### **2. Based on Surgical Approach**
- **Right-sided approach:**  
  Less commonly used, depending on surgeon preference and patient anatomy.
- **Left-sided approach:**  
  More commonly used due to anatomical considerations, such as the position of the esophagus and carotid artery.

---

### **3. Based on Type of Implant or Material Used**
- **Interbody spacers:**  
  - **PEEK (polyetheretherketone) spacers.**  
  - **Titanium spacers.**  
  - Biological materials such as **autografts or allografts.**
- **Cervical plates:**  
  Placed with screws to enhance stability.
- **ACDF without plates:**  
  Utilizes standalone devices or implants integrated into the spacer.

---

### **4. Based on Fusion Technique**
- **Static fusion:**  
  Implants designed to maintain a fixed position between vertebrae.
- **Dynamic fusion:**  
  Implants allowing initial controlled movement to encourage bone healing.

---

### **5. Based on Surgical Goals**
- **Simple decompression:**  
  Indicated for radiculopathy or myelopathy caused by herniated discs.
- **Deformity correction:**  
  Addressing cervical lordosis or more complex spinal deformities.

---

### **6. Based on Postoperative Radiological Outcomes**
- **Solid fusion:**  
  Complete bony consolidation between adjacent vertebrae.
- **Pseudoarthrosis:**  
  Failure of fusion with persistent motion at the treated segment.
- **Implant failure:**  
  Displacement or malposition of the plate or interbody spacer.

---

### **Additional Classifications Relevant to ACDF**
- **Modic Classification:**  
  Identifies degenerative changes in vertebral endplates.
- **Pfirrmann Classification:**  
  Grades disc degeneration.